Bilateral Tonic Pupils Secondary to Ross Syndrome: A Case Report

Is Ross Syndrome an Autoimmune Entity? A Case Series of 11 Patients

“…Mean age of presentation for women was 31 years (22-42) and for men was 27 years . The mean duration of time delay from the onset of symptoms to diagnosis of the disease was 6 years (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). In all patients, this clinical entity was suspected and diagnosed in a tertiary care center.…”

“…5 This benign, progressive autonomic dysfunction has been known to have a slight male preponderance with no specific ethnic predisposition. 5 The disease has been known to occur in any age group and is diagnosed more often in patients in their third decade of life. 5 Hypohidrosis in Ross syndrome is segmental and progressive.…”

“…5 The disease has been known to occur in any age group and is diagnosed more often in patients in their third decade of life. 5 Hypohidrosis in Ross syndrome is segmental and progressive. This is secondary to damage to postganglionic sympathetic fibers innervating the sweat glands.…”

“…6 The aberrant regeneration of nerve fibers following damage to parasympathetic cholinergic fibers between iris and ciliary ganglion leads to progressive miosis in these patients. 5,6,8 The reason for the lost or diminished deep tendon reflexes seen in patients with Ross syndrome remains unknown. The damage of the dorsal root ganglia or the spinal interneuron loss has several postulated causes.…”

Holmes-Adie syndrome

“…Holmes-Adie syndrome has been suggested to be associated with Sjögren's disease, temporal arteritis, and rheumatoid arthritis, and it can also present as a paraneoplastic syndrome in association with lung and breast malignancies [10]. Holmes-Adie syndrome is also believed to occur in association with autoimmune hepatitis and coeliac disease [11].…”